Chronic Complications Of Type Research Articles

Incident Cancer Risk of Patients with Prevalent Type 2 Diabetes Mellitus in Hungary (Part 2).

(1) Background: Among the chronic complications of type 2 diabetes mellitus, cancer has become the leading cause of death in several countries. Our objective was to determine whether prevalent type 2 diabetes mellitus is associated with a higher incidence of cancer. (2) Methods: This study comprised a nationwide analysis conducted in Hungary. The study population was divided into two groups: a type 2 diabetes mellitus group vs. a non-diabetic group. The primary outcome was the risk related to overall cancer incidence; a key secondary outcome was the overall incidence of cancer in distinct study years; and a further outcome was the annual percent changes. (3) Results: The odds ratio related to the overall incidence of cancer was 2.50 (95% confidence interval: 2.46-2.55, p < 0.0001) in patients with diabetes as related to non-diabetic controls. The odds ratio was higher in males than in females [ORmales: 2.76 (2.70-2.82) vs. ORfemales: 2.27 (2.22-2.33), p < 0.05 for male-to-female comparison]. The annual cancer incidence rate declined in non-diabetic controls, but not in patients with diabetes [-1.79% (-2.07--1.52%), p < 0.0001] vs. -0.50% (-1.12-+0.10%), p = 0.0991]. Several types of cancer showed a decreasing tendency in non-diabetic controls, but not in patients with type 2 diabetes. (4) Conclusions: Type 2 diabetes is associated with a higher risk of cancer. While the cancer incidence decreased for non-diabetic individuals with time, it remained unchanged in patients with T2DM.

Estimated glucose disposal rate as a predictor of chronic complications in type 1 diabetes - a cross-sectional study

Estimated glucose disposal rate as a predictor of chronic complications in type 1 diabetes - a cross-sectional study

Hypogonadism and and chronic complications in type 2 diabetic males

Hypogonadism and and chronic complications in type 2 diabetic males

Chronic complications of type 2 diabetes: time from diagnosis to the appearance of complications and the influence of glucoregulation on complications

Chronic complications of type 2 diabetes: time from diagnosis to the appearance of complications and the influence of glucoregulation on complications

Unsupervised cluster analysis of clinical and metabolite characteristics in patients with chronic complications of T2DM: an observational study of real data.

The aim of this study was to cluster patients with chronic complications of type 2 diabetes mellitus (T2DM) by cluster analysis in Dalian, China, and examine the variance in risk of different chronic complications and metabolic levels among the various subclusters. 2267 hospitalized patients were included in the K-means cluster analysis based on 11 variables [Body Mass Index (BMI), Systolic Blood Pressure (SBP), Diastolic Blood Pressure (DBP), Glucose, Triglycerides (TG), Total Cholesterol (TC), Uric Acid (UA), microalbuminuria (mAlb), Insulin, Insulin Sensitivity Index (ISI) and Homa Insulin-Resistance (Homa-IR)]. The risk of various chronic complications of T2DM in different subclusters was analyzed by multivariate logistic regression, and the Kruskal-Wallis H test and the Nemenyi test examined the differences in metabolites among different subclusters. Four subclusters were identified by clustering analysis, and each subcluster had significant features and was labeled with a different level of risk. Cluster 1 contained 1112 inpatients (49.05%), labeled as "Low-Risk"; cluster 2 included 859 (37.89%) inpatients, the label characteristics as "Medium-Low-Risk"; cluster 3 included 134 (5.91%) inpatients, labeled "Medium-Risk"; cluster 4 included 162 (7.15%) inpatients, and the label feature was "High-Risk". Additionally, in different subclusters, the proportion of patients with multiple chronic complications was different, and the risk of the same chronic complication also had significant differences. Compared to the "Low-Risk" cluster, the other three clusters exhibit a higher risk of microangiopathy. After additional adjustment for 20 covariates, the odds ratios (ORs) and 95% confidence intervals (95%CI) of the "Medium-Low-Risk" cluster, the "Medium-Risk" cluster, and the"High-Risk" cluster are 1.369 (1.042, 1.799), 2.188 (1.496, 3.201), and 9.644 (5.851, 15.896) (all p<0.05). Representatively, the "High-Risk" cluster had the highest risk of DN [OR (95%CI): 11.510(7.139,18.557), (p<0.05)] and DR [OR (95%CI): 3.917(2.526,6.075), (p<0.05)] after 20 variables adjusted. Four metabolites with statistically significant distribution differences when compared with other subclusters [Threonine (Thr), Tyrosine (Tyr), Glutaryl carnitine (C5DC), and Butyryl carnitine (C4)]. Patients with chronic complications of T2DM had significant clustering characteristics, and the risk of target organ damage in different subclusters was significantly different, as were the levels of metabolites. Which may become a new idea for the prevention and treatment of chronic complications of T2DM.

Foot drop in children with newly diagnosed type 1 diabetes: three case reports.

The etiology of foot drop is diverse from various diseases to mechanic injuries and includes neuropathy of the peroneal nerve. Peroneal neuropathy might also be one of the forms of diabetic neuropathy, very rarely reported as the first sign of diabetes. We describe three cases of children with newly diagnosed type 1 diabetes (TID) who developed unilateral peroneal nerve palsies and tibial nerve palsies, presenting clinically as a foot drop. In two of our cases, the symptoms of foot drop occurred shortly after starting treatment for severe diabetes ketoacidosis. In the third patient, food drop was a reason for the initial medical consultation, but eventually, TID was diagnosed. The presented cases highlight that neuropathy can be observed not only as a chronic complication of T1D, but it can also appear at the time of disease manifestation. The incorrect position of the lower limb during a keto coma may contribute to the development of neuropathy. Neuropathy can be observed not only as a chronic complication of type 1 diabetes (T1D), but it can also appear at the time of disease manifestation. The incorrect position of the lower limb causing external pressure during a keto coma may contribute to the development of neuropathy. It is important to examine the glycemia in patients with acute peroneal neuropathy, as this kind of peripheral neuropathy can be associated with newly diagnosed T1D. Normalization of glycemia might lead to rapid neuronal recovery.

Evaluation of Pulmonary Functions in Patients With Type 2 Diabetes Mellitus: A Cross-Sectional Study.

Introduction Diabetes mellitus (DM) has been broadly recognized as the syndrome of hyperglycemia leading to various macro- and microvascular complications. The different physiological systems that have been identified as a target of these injurious effects of hyperglycemia are the excretory system, ocular system, central nervous system, and cardiovascular system. To date, not much focus has been given to the respiratory system as a possible target for the deleterious effect of hyperglycemia. Objective To assess the pulmonary functions in subjects with type 2 diabetes mellitus (T2DM) and compare them with age and sex-matched healthy controls. Methods This study was conducted on one hundred and twenty-five patients with type 2 diabetes mellitus and a comparative number of age and sex-matched non-diabetic individuals (control group) who met the inclusion and exclusion criteria.RMS Helios 401 computerized spirometer was used to assess pulmonary functions. Results The mean age of the control group and type 2 diabetics were 50.96±6.85 and 51.47±8.43 years, respectively. The results of the present study showed significantly lower values of FVC, FEV1, FEF25-75%, and MVV among diabetic subjects as compared to controls (<0.05). Conclusion We found that pulmonary function parameters in diabetic subjects were consistently lower than in healthy controls.This reduction in lung function is probably a chronic complication of type 2 diabetes mellitus.

Vitamin D ameliorates insulin resistance-induced osteopenia by inactivating the nucleotide-binding oligomerization domain-like receptor protein 3 inflammasome

ObjectiveOsteoporosis (OP) can be considered a chronic complication of type 2 diabetes mellitus (T2DM). Aberrant activation of the nucleotide-binding oligomerization domain-like receptor protein 3 (NLRP3) inflammasome is associated with the pathogenesis of various inflammation-related diseases, e.g., T2DM and OP. Vitamin D affects the inflammatory pathway and inhibits an excessive inflammatory response. The current study investigated the inter-relationship between vitamin D and inflammasome activation in T2DM. MethodHepatocellular carcinoma (HepG2) cells and bone marrow stromal cells (BMSCs) were treated with Conditioned Medium of bone marrow mesenchymal stem cells after VitD treatment (CM-VitD), as well as phosphoinositide 3-kinase (PI3K) specific agonist, 740Y-P, or the PI3K specific inhibitor, LY294002, respectively, or both. 40 Eight-week-old female Sprague Dawley rats were selected and established as a DM model. The rats were injected with CM-VitD, as well as the 740Y-P specific agonist, or the LY294002 inhibitor, respectively, or both. A quantitative reverse transcription polymerase chain reaction and western blotting were conducted to evaluate the expression of messenger ribonucleic acid and protein in the RUX2 gene, alkaline phosphatase (ALP), OsteoPontiN (OPN), peroxisome proliferator-activated receptor gamma (PPARγ), fatty acid-binding protein 4 (FABP4), protein kinase B (AKT), PI3K, NLRP3, apoptosis-associated speck-like protein containing a caspase recruitment domain (ASC), caspase-1, interleukin (IL)-1 beta (β), IL-18, and tumor necrosis factor alpha (TNF-α) in the BMSCs and liver tissue of rats. Enzyme-linked immunosorbent assay was used to detect the concentration of inflammatory factors in the cell supernatant and serum of rats. ResultsAn isolated co-culture of HepG2/insulin-resistance cells and BMSCs promoted the adipogenic transformation of the latter and inhibited the transformation of BMSCs into osteogenesis. The PI3K specific agonist, 740Y-P, significantly increased the expression of PI3K, AKT, NLRP3, ASC and Caspase-1 while the PI3K specific inhibitor, LY294002, does the opposite. Additionally, CM-VitD reduced the expression of NLRP3, ASC, caspase-1, IL-1β, and IL-18 in BMSCs and rat liver via the PI3K/AKT pathway. ConclusionVitamin D can inhibit the inflammatory response induced by T2DM and promote the osteogenesis of BMSCs, which may play a key role in the treatment of type 2 diabetes patients with OP.

Relationship of liver fat content with systemic metabolism and chronic complications in patients with type 2 diabetes mellitus

ObjectiveThis study investigated the correlation of liver fat content (LFC) with metabolic characteristics and its association with chronic complications in type 2 diabetes mellitus (T2DM) patients.MethodsEighty-one prospectively enrolled T2DM patients were divided into non-alcoholic fatty liver disease (NAFLD) group and the non-NAFLD group according to the presence of NAFL complications. LFC was determined by MRI IDEAL-IQ Sequence, and patients were divided into 4 groups according to LFC by quartile method. Basic information, metabolic indexes, and occurrence of chronic complications in different groups were analyzed and compared.ResultsBMI, SBP, DBP, TG, ALT, AST, GGT, UA, HbA1c, FCP, 2 h CP, HOMA-IR, and HOMA-IS in the NAFLD group were significantly higher than the non-NAFLD group (P < 0.05). The incidences of chronic complications in the NAFLD group were higher than in the non-NAFLD group but not statistically significant (P > 0.05). BMI, SBP, DBP, TC, TG, ALT, AST, FCP, 2 h CP, HOMA-IR, and HOMA-IS showed significant differences between the patients with different LFC, and these indexes were significantly higher in patients with higher LFC than those with lower LFC (P < 0.05). Moreover, diabetes duration, TC, HOMA-IR, and LFC were the risk factors for ASCVD complications, while diabetes duration, TG, and LDL-C were risk factors for DN complications. Also, diabetes duration and SBP were risk factors for both DR and DPN complications in T2DM patients (P < 0.05).ConclusionLFC is positively correlated with the severity of the systemic metabolic disorder and chronic complications in T2DM patients.

血清肌酐与胱抑素C比值与2型糖尿病慢性并发症的相关性分析

血清肌酐与胱抑素C比值与2型糖尿病慢性并发症的相关性分析

Trends in glycemic control, cardiovascular risk factors and chronic complications of type 2 diabetes, 2012–2016, in a healthcare area of Barcelona

AimsThis study aimed to analyse the evolution of the metabolic control, cardiovascular risk factors and chronic complications in a Type 2 Diabetes (T2D) population in a healthcare area of Barcelona. MethodsWe carried out a comparative study of T2D patients (20.457) between 2012 and 2016 (data recorded in the “Electronic Clinical-Station in Primary Care”) concerning: age, gender, body mass index (BMI), arterial blood pressure (BP), HbA1c, LDL-Cholesterol, smoking, heart failure (HF), micro and macrovascular complications. ResultsAverage HbA1c was 6.9 % in 2012 and 7 % in 2016 (Non significant differences)(NS). In 2012, 57.9 % of patients presented proper glycaemic control, 42.8 % LDL-Cholesterol < 100 mg/dL and 76.9 % BP < 140/90 while in 2016 it was 61.2 % (NS), 59.2 % (p = 0.001) and 82.9 % (p = 0.016) respectively. No changes were found in BMI or active smoking. Significant increases were found in the prevalence of microvascular complications, HF and peripheral vasculopathy (PV). Patients with vascular diseases (PVD) and adequate metabolic control increased from 57.5 % to 62.7 % (p = 0.006). Albuminuria > 30 mg/g were more frequent among PVD. ConclusionsBetween 2012 and 2016 it was observed that, amongst our study population, glycaemic control was steady and cholesterol and BP levels were improved, while there was a significant increase of diabetic complications, HF and PV.

FLOW MEDIATED-DILATATION IS ALREADY ABNORMAL IN PRE-IMPAIRED GLUCOSE TOLERANCE (PRE-IGT) AND WITH NO CORRELATION WITH SYSTOLIC BLOOD PRESSURE AND DIASTOLIC BLOOD PRESSURE

Objective: Pre-impaired glucose tolerance (Pre-IGT) is a stage of compensatory hyperinsulinemia to maintain normoglycemia. It is the earliest stage of glucose dysmetabolism, where beta cells can still compensate for the insulin resistance thru hyperinsulinemia. Endothelial dysfunction is a critical part in the pathogenesis of macrovascular and microvascular chronic complications in type 2 diabetes, ordinarily due to uncontrolled hyperglycemia. In pre-IGT the main problem is hyperinsulinemia on a background of normal blood sugar. C-peptide, a segment cleaved off from pro-insulin is equimolar to insulin, and has shown to cause intima media thickening. This study was undertaken to determine endothelial function of patients with pre-IGT thru flow-mediated dilatation of the brachial artery and to correlate the FMD with the insulin level, systolic blood pressure and diastolic blood pressure. Design and method: This is a cross-sectional analytical study of adult patients with risk factors for developing diabetes such as, having first-degree relative with diabetes, obesity, history of gestational diabetes, and polycystic ovary syndrome (PCOS). Systolic and diastolic BP, BMI, 2-hour serum insulin, blood sugar, and lipids were determined. Patients with pre-IGT underwent brachial artery FMD. Results: Of the 27 subjects, 21 (77.8%) had pre-IGT. The mean oral glucose tolerance test at 2-hours post-prandial was normal at 109.53 mg/dL (SD = 30.26). Results of the laboratory tests were as follows: mean Hba1c and insulin at 2 hours were 5.34% (SD = 0.44) and 112.21 uIU/mL (SD = 111.24, normal range 2.60–24.90), respectively. Comparative analyses of the demographic and clinical profiles showed similar characteristics between the normoinsulinemic and the pre-IGT subjects (p &gt; 0.05), although there were more with positive history of type 2 DM and obesity on the latter group. Systolic and diastolic BP levels were normal. Of the 27 subjects, four (4) had abnormal FMD which had a small positive correlation with thee insulin level, systolic BP, and diastolic BP, although not statistically significant (p &gt; 0.05). Conclusions: Endothelial dysfunction has shown to exist already in the pre-IGT subjects depicted in the abnormality in the arterial flow-mediated dilatation study. Systolic BP and diastolic BP levels have not shown any significant correlation with the FMD finding, and the insulin level.

Interleukin-6 Levels in Patients With Diabetic Polyneuropathy

IntroductionDiabetic polyneuropathy (DPN) is a common chronic complication of type 2 diabetes. The pathogenesis of DPN is still debated, but proinflammatory cytokine mediators like interleukin-6 (IL-6) are possibly involved. We conducted this cross-sectional observational study to assess whether IL-6 levels increase in patients with DPN.Materials and methodsThis study was conducted at the Institute of Post Graduate Medical Education and Research Hospital in Kolkata, India, from 2016 to 2017. The study included 57 patients aged 30 to 60 years diagnosed with type 2 diabetes with neuropathy on clinical examination and nerve conduction study. Patients with neuropathy due to other causes were excluded. The study participants were assigned into one of four groups. Group 1 (n=15) served as healthy control patients, Group 2 (n=12) contained patients with type 2 diabetes without neuropathy, Group 3 (n=20) contained patients with type 2 diabetes with painful neuropathy, and Group 4 (n=10) contained patients with type 2 diabetes with painless neuropathy. We compared IL-6 levels between each group. ResultsThere was no significant difference in serum IL-6 levels between healthy controls (Group 1) and patients with type 2 diabetes without neuropathy (Group 2). However, we noted a significant increase in serum IL-6 levels among patients with painful DPN (Group 3) compared to control groups. Interestingly, serum IL-6 levels were higher in patients with painful DPN (Group 3) than patients with painless DPN (Group 4).ConclusionsIL-6 increases significantly in painful diabetic neuropathy patients compared to patients with diabetes with painless neuropathy and thus may have a role in the pathogenesis of pain in DPN. Serum IL6 level can be a potential noninvasive marker of painful DPN, and it can help distinguish painful DPN from other causes of pain in patients with diabetes.

The Relationship of Hyperferritinemia to Metabolism and Chronic Complications in Type 2 Diabetes.

AimElevated serum ferritin has been found to be closely related to type 2 diabetes mellitus. This study aimed to explore the relationship of high serum ferritin to metabolism and chronic complications in type 2 diabetes.MethodsThis was a cross-sectional study. A total of 330 type 2 diabetes patients who visited an endocrine clinic were included for the analysis. Serum ferritin and metabolic parameters were recorded. The prevalence of chronic diabetic complications was evaluated. Based on serum ferritin, participants were divided into hyperferritinemia and normal-ferritin groups. Metabolic parameters and prevalence of chronic diabetic complications were compared. The relationship between hyperferritinemia and chronic diabetic complications was explored with multivariate logistic regression models. Data were statistically analyzed by sex.ResultsCompared with the normal-ferritin group, the hyperferritinemia group showed higher levels of the serum inflammatory marker CRP and higher prevalence of diabetic retinopathy (DR) and coronary heart disease (CHD), regardless of sex (p<0.05). Moreover, male patients with hyperferritinemia had increased serum triglyceride, alanine transferase, γ-glutamyltranspeptidase, urea nitrogen, creatinine, and uric acid and higher prevalence of microalbuminuria (p<0.01). After controlling for demographics and metabolic profiles, hyperferritinemia remained an independent risk factor of DR (male OR 3.957, 95% CI 1.559–10.041, p=0.004; female OR 2.474, 95% CI 1.127–5.430, p=0.024) and CHD (male OR 2.607, 95% CI 1.087–6.257, p=0.032; female OR 2.293, 95% CI 1.031–5.096, p=0.042).ConclusionThis study found that hyperferritinemia was associated with increased CRP and higher prevalence of DR and CHD in type 2 diabetes. In men, high serum ferritin was also associated with dyslipidemia, hepatic dysfunction, and microalbuminuria.

Overt hypogonadism is a cardiovascular risk factor in type 2 diabetic males: An observational study.

We aimed to evaluate the effects of hypogonadism on metabolic and chronic complications in type 2 diabetic males. 261 nonobese males with type 2 diabetes aged 18-70 were involved in the study. Hypononadal males were divided into 2 groups as overt hypogonadism (total testosterone≤230ng/dl) and borderline hypogonadism (230-345ng/dl). The control group involved eugonadal diabetic males. Micro-macrovascular complications were recorded. 101 patients had hypogonadism (38.7%), and 160 patients were eugonadal (61.3%). Microvascular complication rate was not different, but macrovascular complication rate was significantly higher in hypogonadal males (42.6%/31.3%, p=0.042). Optimal glycosylated haemoglobin (HbA1c) achievement(<7%) was significantly lower in hypogonadal patients (20.8%/31.3%, p=0.043). Poor glycaemic control (HbA1c≥7%), presence of microvascular complication and increased triglyceride levels were independent risk factors for hypogonadism (OR: 1.5, p=0.044;OR:3.89,p=0.025 and OR: 1.0, p=0.016 respectively). Overt hypogonadism, hypertension, hypercholesterolaemia and severe hypoglycaemia were independent risk factors for macrovascular complications (OR: 1.0, p=0.027; OR:2.6, p=0.002; OR: 1.8, p=0.047 and OR: 1.0, p=0.007 respectively), diabetes duration (≥5years) and poor glycaemic control for microvascular complication (OR: 1.0, p=0.031 and OR:2.0, p=0.028). As a result, hypogonadism is frequent among diabetic males and poor glycaemic control may be an important contributing factor. Furthermore overt hypogonadism is an important cardiovascular risk marker. Therefore, ensuring eugonadism in diabetic patients may positively affect both glycaemic control and complications.

Роль синдрому обструктивного апное сну в атеросклеротичному ушкодженні сонних артерій при цукровому діабеті 2-го типу

Актуальність. Синдром обструктивного апное сну є одним із найпоширеніших порушень сну. На цей час накопичено достатньо даних про негативний вплив синдрому обструктивного апное сну на розвиток хронічних ускладнень цукрового діабету (ЦД) 2­го типу. Мета. Оцінювання стану ліпідного профілю крові та атеросклеротичних змін сонних артерій у пацієнтів із ЦД 2­го типу залежно від наявності синдрому обструктивного апное сну. Матеріали та методи. У дослідженні взяли участь 55 чоловіків. Усім пацієнтам виконано полісомнографічне дослідження, ультразвукове дослідження сонних артерій, визначення показників глікованого гемоглобіну, загального холестерину, тригліцеридів, ліпопротеїнів високої і низької щільності, визначення антропометричних показників. Учасники дослідження розподілені на 3 групи: група 1 (n = 15) — пацієнти з ЦД 2­го типу без синдрому обструктивного апное сну, група 2 — пацієнти з ЦД 2­го типу та синдромом обструктивного апное сну, група 3 — пацієнти із синдромом обструктивного апное сну без порушень вуглеводного обміну. Результати. Аналіз результатів вказує на те, що синдром обструктивного апное сну відзначається у 73 % випадків у пацієнтів із ЦД 2­го типу (у 28 % пацієнтів — синдром обструктивного апное сну середнього ступеня тяжкості та в 42 % — тяжкого ступеня). У групах пацієнтів із синдромом обструктивного апное сну відзначається зниження коефіцієнта ефективності сну, тривалості сну, подовження тривалості неспання після засипання. Збільшення індексу апное/гіпопное сну пов’язано зі збільшенням рівня загального холестерину, ліпопротеїнів низької щільності, тригліцеридів у пацієнтів із ЦД 2­го типу та синдромом обструктивного апное сну. Значення товщини комплексу інтима­медіа сонної артерії у групах із синдромом обструктивного апное сну корелює з більшим навантаженням індексу апное/гіпопное і зниженням насичення крові киснем; збільшення товщини комплексу інтима­медіа в 100 % випадків пов’язано з наявністю хропіння. Висновки. Синдром обструктивного ­апное сну у пацієнтів із ЦД 2­го типу і надмірною масою тіла у поєднанні з нічною гіпоксемією і хропінням пов’язаний із розвитком атеросклерозу сонних артерій.

Does concomitance of Hashimoto's disease and type 1 diabetes affect diabetes control and development of its complications?

IntroductionAutoimmune diseases concomitant with diabetes may complicate the treatment and adversely affect the prognosis. The most common is Hashimoto’s disease (HD). We compared diabetes control and prevalence of chronic complications in type 1 diabetes patients differing in the coexistence of HD.Material and methodsMedical records of 188 type 1 diabetics were analysed. Hashimoto’s disease was diagnosed based on medical history, as well as determination of the levels of thyroid peroxidase antibodies, hormones and ultrasound examination. Statistical analysis was performed using Statistica 10PL.ResultsHD was diagnosed in 43 (23%) patients. The mean HbA1c was 8.8 ±1.5% in the group with HD, and 9 ±1.6% in the group without HD (ns). The prevalence of diabetes complications was similar in both groups: ischaemic heart disease was diagnosed in 19% of patients with HD and 19% without HD, cerebral vascular insufficiency – 8% and 7%, peripheral neuropathy – 14% and 12%, sensory polyneuropathy – 47% and 46%, diabetic foot – 7% and 8%, Charcot osteoarthropathy – 7% and 2%, cardiovascular neuropathy – 21% and 28%, neuropathy of the gastrointestinal tract – 5% and 6%, nephropathy – 12% and 19%, retinopathy – 42% and 43%, and cataract in 28% and 19%, respectively. Impaired hypoglycaemia perception was rarer in the group with HD: 9% vs. 25% (p ≈ 0.04).ConclusionsHashimoto’s disease does not significantly affect the level of type 1 diabetes control or the development of its complications. Only autonomic neuropathy in the form of impaired awareness of hypoglycaemia is rarer in patients with that thyroiditis.

Psychiatric illness, emotional distress, glycemic control and chronic complications in type 1 diabetes subjects.

To assess the prevalence of psychiatric disorders in patients with type 1 diabetes mellitus (T1D) and to compare patients with and without psychiatric disorder. We made a cross-sectional study including patients with T1D assisted in the outpatient clinics of the Brazilian National Health System. To assess depression and anxiety, we used the PHQ-9 questionnaire and the DSM-5th edition criteria, respectively. B-PAID evaluated the level of emotional distress associated with diabetes; EAT-26, eating disorders; SCI-R, adherence to the proposed clinical treatment. We analyzed 166 patients aged 33 (22-45.2) years, 53.6% female. The prevalence of depression and anxiety was 20.5% and 40.4%, respectively. HbA1c was worse in the depressed (9.0% vs. 8.4%, p = 0.008), in the anxious ones (9.0% vs. 8.3%, p = 0.012) and in the patients with high levels of B-PAID (8.8 % vs. 8.3 %, p = 0.009). There was no difference in the prevalence of complications related to diabetes. The prevalence of psychiatric disorders and emotional distress related to diabetes was high in our population of T1D patients, and depression and high levels of B-PAID were associated with the worse glycemic control.

HUBUNGAN KADAR GLUKOSA DARAH DAN KADAR HbA1c DENGAN STATUS FUNGSI KOGNITIF PASIEN DIABETES MELLITUS TIPE 2 DI RUMAH SAKIT MARINIR CILANDAK TAHUN 2019

Relationship between Blood Glucose Levels and Hba1c Levels with Cognitive Function Status of Type 2 Diabetes Mellitus Patients at the Cilandak Marine Hospital in 2019 Background: Hyperglycemic and insulin resistance can lead to chronic complications in type 2 diabetes patients with long treatment such as macro vascular, micro vascular and neuropathic complication. This may cause alteration and disruption in various system, included the center of nerve system, that related to cognitive function. Objective: This research aimed to analyze the correlation between cognitive status with blood glucose levels and HbA1c level in type 2 diabetes mellitus patients at Marinir Cilandak Hospital. Methods: This research was an analytic observational research with the approach of Cross Sectional method. The study sample included populations with the inclusion and exclusion criteria of 40 respondents. Samples in this study was calculated using Consecutive Sampling. Results: The results showed multivariate analysis that the entire of the independent variables with cognitive status obtained p value = <0,001 (p <0,05). Conclusion: There was significant correlation between blood glucose levels and HbA1c levels with cognitive status in type 2 diabetes mellitus patients.

The relationship of neutrophil elastase and proteinase 3 with risk factors, and chronic complications in type 2 diabetes: A Fenofibrate Intervention and Event Lowering in Diabetes (FIELD) sub-study

Introduction:Neutrophil elastase (NE) and proteinase 3 (PR3) are novel inflammation biomarkers. We investigated their associations with chronic complications, determinants of biomarker levels and effects of fenofibrate in patients with type 2 diabetes mellitus (T2DM) from Fenofibrate Intervention and Event Lowering in Diabetes study.Methods:Plasma NE and PR3 levels were quantified at baseline (n = 2000), and relationships with complications over 5-years assessed. Effects of fenofibrate on biomarker levels (n = 200) were determined at four follow-up visits.Results:Higher waist-to-hip ratio, homocysteine and C-reactive protein and lower apoA-II were determinants of higher NE and PR3 levels. Higher NE levels were associated with on-trial stroke and cardiovascular mortality, and higher PR3 levels with on-trial stroke, but associations were not significant after adjustment for confounding factors. Although higher NE and PR3 levels were associated with baseline total microvascular disease, only NE levels were associated with on-trial neuropathy or amputation. These associations were not significant after adjusting for multiple comparisons. NE and PR3 levels did not change with fenofibrate.Conclusions:In T2DM plasma NE and PR3 levels are associated with vascular risk factors, and total microvascular disease at baseline, but on rigorous analyses were not associated with on-trial complications. Levels were not changed by fenofibrate.